TUESDAY, Nov. 13 (HealthDay News) -- Tiny devices that allow
fluid to drain from the eye could reduce the dangerously high
pressure in the eyes of glaucoma patients.
These "micro-stents" -- including one that's newly available and
others that are under development -- come with caveats. They may
not protect the eyes from glaucoma in the long term, and it's
unclear if they're effective when not used in conjunction with
Still, research continues. This week, scientists released a
preliminary study of one type of micro-stent that says it allowed
most patients to avoid having to take eye drops to control their
eye pressure. Dr. Thomas Samuelson, a glaucoma specialist with
Minnesota Eye Consultants, was the study's medical monitor.
Dr. James Salz, a spokesman for the American Academy of
Ophthalmology and clinical professor of ophthalmology at the
University of Southern California, said that the future of the use
of the devices depends on whether the "success rate is high and
complication rate is low."
In many patients with glaucoma, the fluid inside the eye creates
pressure that damages the optic nerve. Most glaucoma patients are
able to control their eye pressure with eye drops and don't need
surgery. But the drops can cost as much as $100 a month and require
patients to use them for decades, Salz said.
Those aren't the only drawbacks to eye drops, another expert
Many patients don't like the drops and fail to use them on a
regular basis, said Dr. Alfred Sommer, a professor of ophthalmology
at Johns Hopkins University in Baltimore and dean emeritus of
Hopkins' Bloomberg School of Public Health. Another option is
surgery to allow better draining of the fluid in the eye.
In June, the U.S. Food and Drug Administration approved a
"mini-stent" known as the iStent to treat glaucoma patients who
also have a cataract. The stent, a tiny tube of titanium, is
designed to allow better draining of eye fluid.
In a new study, scheduled to be presented Tuesday at the annual
meeting of the American Academy of Ophthalmology in Chicago,
researchers tested the Hydrus stent, another kind of titanium
stent, on 69 patients with mild to moderate glaucoma.
Forty of the patients also had cataracts and underwent the stent
procedure during cataract surgery, which often helps reduce eye
pressure on its own. After six months, 85 percent of them saw their
eye pressure improve to the point that they didn't need to use eye
drops. The number was 70 percent among those who didn't require
The results persisted at the one-year time point.
As for cost, the stents may not cost more than a few hundred
dollars, Salz said. Side effects can include scarring, he noted.
However, the new study reports no complications.
In a news release, the American Academy of Ophthalmology noted
that the iStent has been approved and several other kinds of stents
are under development. "Despite encouraging initial results, it
will be several years before the long-term safety, efficacy and
durability of this treatment approach can be fully confirmed," the
Sommer questioned whether the lowered pressure level is
significant enough in the study patients who received the stent.
The findings also don't make it clear what happened to the
peripheral vision of the patients, which can be disrupted by
glaucoma, he said.
For his part, Salz said it's not clear if the stents will
ultimately be used in any patients who don't have cataracts. Still,
"if the long-term success looks good, they may consider putting
them in eyes that don't have cataracts."
Neither Sommer nor Salz was involved with the research.
Because this study was presented at a medical meeting, the data
and conclusions should be viewed as preliminary until published in
a peer-reviewed journal.
For more about
glaucoma, visit the U.S. National Library of Medicine.
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